Senior Care Manager, RN

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $75.3k - $135.4k / year

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Support high-risk members through assessments, individualized care planning, outreach, and complex caseload management • Assist with case setup and backup training • Assess, plan, and implement complex care management activities to enable quality, cost-effective healthcare outcomes • Develop personalized care plans/service plans and address members’ unmet needs • Educate members and families/caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits • Continuously assess care plans and collaborate with providers to identify specialists and community resources • Coordinate between members/families/caregivers and care provider teams to ensure adequate, appropriate person-centered care • Monitor member status, changes in condition, progress, and care plan goals; revise plans as needed • Identify problems, barriers, and interventions for escalated cases • Review member data, referrals, and intake assessments to improve operating performance, quality care, and care planning • Perform telephonic, digital, home, and/or other site outreach • Collaborate with healthcare providers to facilitate services/treatments and revise care plans • Collect, document, and maintain member information and care management activities for regulatory compliance • Partner with leadership to improve cost-effective care and quality delivery • Precept clinical new hires, foster core skills, coach growth, and guide onboarding • Provide guidance, support, coaching, and shadowing to clinical new hires/preceptees in an MCO • Complete competency checkpoints and assess readiness for Service Coordination success • Collaborate with People Leaders and cross-functional teams to measure and monitor readiness • Perform other duties as assigned and comply with all policies and standards

🎯 Requirements

• Candidates must reside in North Carolina • NC RN license required • RN - Registered Nurse - State Licensure and/or Compact State Licensure required • Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing • 4–6 years of related experience • Monday–Friday, 8:00 a.m.–5:00 p.m. schedule, with flexibility available after training • Knowledge/experience in care management • Ability to assess high-risk members and manage complex caseloads • Ability to develop and maintain individualized care plans/service plans • Ability to collaborate with members, caregivers, providers, specialists, community resources, leadership, and cross-functional teams • Ability to document member information and care management activities in compliance with state, federal, and third-party payer regulations

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules • additional forms of incentives may be included in total compensation • diversity-focused equal opportunity employer